Abdominal-only Compression Garments Reduce Orthostatic Tachycardia and Improve Symptoms in Patients With Postural Orthostatic Tachycardia Syndrome

Q: What does this research mean for the field?

Commercially available abdominal-only compression garments reduce orthostatic tachycardia and improve symptoms acutely and over several hours in patients with postural orthostatic tachycardia syndrome. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Kate M. Bourne; Kavithra Karalasingham; Tanya Siddiqui; Bianca Mammarella; Derek V. Exner; Robert S. Sheldon; Satish R. Raj

doi:10.1016/j.cjca.2025.11.038

December 1, 2025Canadian Journal of CardiologyOpen Access

Abdominal-only Compression Garments Reduce Orthostatic Tachycardia and Improve Symptoms in Patients With Postural Orthostatic Tachycardia Syndrome

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Why the study?

Compression garments are inexpensive and easy to implement, but the longer term benefits of abdominal compression in a real-world setting were not known in patients with POTS.

Do abdominal compression garments reduce orthostatic tachycardia and improve symptoms in patients with POTS?

Structured PICO

Do abdominal compression garments reduce orthostatic tachycardia and improve symptoms in patients with POTS?

P

Population

Patients with postural orthostatic tachycardia syndrome (POTS)

I

Intervention

Commercially available abdominal compression garments worn during active stand tests

C

Comparator

No abdominal compression garment (active stand tests performed without the garment)

O

Outcome

Standing heart rate (HR) and change in HR with upright posture compared with supinesurrogate

Commercially available abdominal compression garments acutely reduce heart rate and improve symptoms in patients with POTS, offering a practical alternative to full lower-body compression.

Implication

Abdominal compression may ease POTS symptoms in daily life; leaves open whether it should replace full garments pending larger trials.

Abstract

BACKGROUND: Compression garments are a relatively inexpensive and easy-to-implement treatment, but the longer term benefits of abdominal compression in a real-world setting are not known. In this study we sought to evaluate commercially available abdominal compression garments in a real-world setting in patients with postural orthostatic tachycardia syndrome (POTS). METHODS: Participants completed four 10-minute active stand tests, with and without an abdominal compression garment, in the morning (Test #1: AM-OFF; Test #2: AM-ON) and afternoon (Test #3: PM-ON; Test #4: PM-OFF). Participants held medication that could augment heart rate (HR) and blood pressure during this 1-day study. A Holter monitor was used to record HR and participants recorded their symptoms using the Vanderbilt Orthostatic Symptom Score at the end of each standing test (range 0-90, where 0 = no symptoms). Continuous data are presented as median (25th-75th percentile). RESULTS: Standing HR (103 [91-114] vs 118 [99-134], P = 0.002) and change in HR with upright posture compared with supine (27 [19-42] vs 41 [26-48], P < 0.001) were reduced, and symptoms improved (29 [16-45] vs 35 [25-60], P = 0.005), during AM-ON compared with AM-OFF. When the garment was removed after several hours of use (PM-ON vs PM-OFF), standing HR (P = 0.04), ΔHR (P = 0.01), and symptoms (P = 0.02) increased. CONCLUSIONS: Commercially available abdominal compression garments reduced HR and improved symptoms both acutely and after several hours of use. Abdominal compression garments may provide a good alternative to full waist-high compression garments in patients with POTS. CLINICAL TRIAL REGISTRATION: NCT04881318.